OBJECTIVES: Aim of this study was to investigate the associations of C-reactive protein levels, as marker of low-grade inflammation, with blood pressure development during pregnancy and the risks of gestational hypertensive complications. We also explored the role of maternal BMI in these associations. METHODS: High-sensitivity C-reactive protein levels were measured in early pregnancy (median 13.2 weeks, 95% range 9.6-17.6) in 5816 mothers participating in a population-based prospective cohort study in the Netherlands. Blood pressure measurements were performed in each trimester. Information about pregnancy-induced hypertension and preeclampsia was retrieved from hospital charts of the women. RESULTS: Longitudinal analyses showed that C-reactive protein levels were not associated with SBP and DBP patterns throughout pregnancy. Trimester-specific multivariate linear regression models showed that as compared to low C-reactive protein levels (<5.0 mg/l), elevated levels (≥20.0 mg/l) were associated with maternal SBP and DBP. Elevated C-reactive protein levels in early pregnancy were associated with the risks of pregnancy-induced hypertension [odds ratio (OR) 2.78, 95% confidence interval (CI) 1.66-4.66]. After adjustment for maternal BMI, all associations attenuated. CONCLUSION: Our results suggest that first-trimester C-reactive protein levels are associated with SBP and DBP levels throughout pregnancy and with gestational hypertensive complications, but these associations are largely explained by maternal BMI.

Additional Metadata
Keywords Blood pressure, C-reactive protein, preeclampsia, pregnancyinduced hypertension
Persistent URL dx.doi.org/10.1097/HJH.0b013e32834c58e5, hdl.handle.net/1765/33729
Citation
de Jonge, L.L., Steegers, E.A.P., Ernst, G.D.S., Lindemans, J., Russcher, H., Hofman, A., & Jaddoe, V.W.V-K.. (2011). C-reactive protein levels, blood pressure and the risks of gestational hypertensive complications: The Generation R Study. Journal of Hypertension, 29(12), 2413–2421. doi:10.1097/HJH.0b013e32834c58e5